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The Effect of Hyperfiltration on Kidney Function in Living Donor Kidney Transplantation: A Prospective Cohort Study

ACTA MEDICA INDONESIANA · Vol. 52 No. 3 (2020)

ISSN
2338-2732, 0125-9326
Published
2020-10-04
Publisher
The Indonesian Society of Internal Medicine
Language
eng

Abstract

Background: living kidney donation is a safe medical procedure. Kidney function after donation is crucial for donors’ health and quality of life. Kidney hyperfiltration is a compensatory mechanism, which will preserve kidney function after unilateral nephrectomy. The number of studies regarding hyperfiltration in living kidney donors is limited. Our study aimed to explain kidney hyperfiltration mechanism and evaluate its effect on the kidney function within 30 days after surgery. Methods: our study was a prospective cohort study with 46 living-kidney donors participating in the study between April and December 2019. We evaluated main outcomes, the 30-day post-surgery kidney function, which was evaluated by calculating estimated glomerular filtration rate (eGFR) and Urinary Albumin to Creatinine Ratio (ACR). The subjects were categorized into two groups based on their 30-day outcomes, which were the adaptive (eGFR > 60 mL/min/1.73 m2 and/or ACR > 30 mg/g) and maladaptive (eGFR 30 mg/g) groups. A series of evaluation including calculating the renal arterial resistive index (RI) and measuring urinary vascular endothelial growth factor (VEGF), neutrophil gelatinase-associated lipocalin (NGAL), and heparan sulfate (HS) levels were performed before surgery and serially until 30 days after surgery. Multivariate analysis with adjustments for confounding factors was done. Results: forty donors were included and mostly were female (67.5%). The average age and body mass index (BMI) were 45.85 (SD 9.74) years old and 24.36 (SD 3.73) kg/m2, respectively. Nineteen donors (47.5%) had maladaptive hyperfiltration outcomes. The hyperfiltration process was demonstrated by significant changes in renal arterial RI, urinary VEGF, NGAL, and HS levels (p<0.005). There was no significant difference regarding RI, urinary VEGF, NGAL, and HS levels between both groups. Several confounding factors (BMI over 25 kg/m2, familial relationship, age over 40 years old, and arterial stiffness) were significantly influenced by kidney hyperfiltration and outcomes (p<0.05). Conclusion: the hyperfiltration process does not affect the 30-day post-nephrectomy kidney function of the donors. Several other factors may influence the hyperfiltration process and kidney function. Further study is necessary to evaluate kidney function and its other related variables with a longer period of time study duration.

Keywords

Collaboration network of the authors

40 authors · 105 co-authorship links · showing the 40 most connected

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  • University of Indonesia
  • Affiliation unknown
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Co-authorOrganisationJoint articles
Rudi HartonoAffiliation unknown2
Hamzah ShatriAffiliation unknown2
Pringgodigdo NugrohoAffiliation unknown2
Hadi Sabari YunusAffiliation unknown2
Hafid SetiadiAffiliation unknown2
Vidhia UmamiAffiliation unknown2
Irsan HasanAffiliation unknown2
Em YunirUniversity of Indonesia2
FarukAffiliation unknown1
Achmad MunjidAffiliation unknown1
Maria Johana Ari WidayantiAffiliation unknown1
Aswin Rizal AssegafAffiliation unknown1
Fatma HetamiAffiliation unknown1
Rohaeni RohaeniAffiliation unknown1
Yosia Puri SaputroAffiliation unknown1
Maria Johana Ari WidayantiAffiliation unknown1
mohamad ikhwan rosyidiAffiliation unknown1
Hanna Eka RositaAffiliation unknown1
Nur InayahAffiliation unknown1
Wayan AnggunturAffiliation unknown1
Arif Suryo PriatmojoAffiliation unknown1
Djajadiman GatotAffiliation unknown1
Alida R HarahapAffiliation unknown1
Teny T Sari1Affiliation unknown1
Arwin A.P. AkibAffiliation unknown1
Sri R.S. HadinegoroAffiliation unknown1
Ponpon S IdjradinataAffiliation unknown1
Lugyanti SukrismanAffiliation unknown1
Karmel L TambunanAffiliation unknown1
Catharina SuhartiAffiliation unknown1
Johan KurniandaAffiliation unknown1
Shinta O. WardhaniAffiliation unknown1
Noorwati SoetandyoAffiliation unknown1
Ni Made R.A. RenaAffiliation unknown1

Affiliations come from OpenAlex; journal OAI-PMH metadata carries none. Authors without an OpenAlex ID are matched by name, which can merge or split people.

Metadata source: OAI-PMH (metadata jurnal) http://www.actamedindones.org/index.php/ijim/oai, first harvested 8 Nov 2026, last seen 8 Nov 2026.
Original metadata (oai_dc) 
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	<dc:title xml:lang="en-US">The Effect of Hyperfiltration on Kidney Function in Living Donor Kidney Transplantation: A Prospective Cohort Study</dc:title>
	<dc:creator>Marbun, Maruhum Bonar H.</dc:creator>
	<dc:creator>Susalit, Endang</dc:creator>
	<dc:creator>Aulia, Diana</dc:creator>
	<dc:creator>Pandelaki, Jacub</dc:creator>
	<dc:creator>Bardosono, Saptawati</dc:creator>
	<dc:creator>Purwanto, Bambang</dc:creator>
	<dc:subject xml:lang="en-US">Heparan Sulfate</dc:subject>
	<dc:subject xml:lang="en-US">Hyperfiltration</dc:subject>
	<dc:subject xml:lang="en-US">Living-Donor</dc:subject>
	<dc:subject xml:lang="en-US">Neutrophil Gelatinase-Associated Lipocalin</dc:subject>
	<dc:subject xml:lang="en-US">Resistive Index</dc:subject>
	<dc:subject xml:lang="en-US">Kidney Transplantation</dc:subject>
	<dc:subject xml:lang="en-US">Vascular Endothelial Growth Factor</dc:subject>
	<dc:subject xml:lang="en-US">kidney transplantation</dc:subject>
	<dc:description xml:lang="en-US">Background: living kidney donation is a safe medical procedure. Kidney function after donation is crucial for donors’ health and quality of life. Kidney hyperfiltration is a compensatory mechanism, which will preserve kidney function after unilateral nephrectomy. The number of studies regarding hyperfiltration in living kidney donors is limited. Our study aimed to explain kidney hyperfiltration mechanism and evaluate its effect on the kidney function within 30 days after surgery. Methods: our study was a prospective cohort study with 46 living-kidney donors participating in the study between April and December 2019. We evaluated main outcomes, the 30-day post-surgery kidney function, which was evaluated by calculating estimated glomerular filtration rate (eGFR) and Urinary Albumin to Creatinine Ratio (ACR). The subjects were categorized into two groups based on their 30-day outcomes, which were the adaptive (eGFR &amp;gt; 60 mL/min/1.73 m2 and/or ACR &amp;gt; 30 mg/g) and maladaptive (eGFR &amp;lt; 60 mL/min/1.73 m2 and/or ACR &amp;gt; 30 mg/g) groups. A series of evaluation including calculating the renal arterial resistive index (RI) and measuring urinary vascular endothelial growth factor (VEGF), neutrophil gelatinase-associated lipocalin (NGAL), and heparan sulfate (HS) levels were performed before surgery and serially until 30 days after surgery. Multivariate analysis with adjustments for confounding factors was done. Results: forty donors were included and mostly were female (67.5%). The average age and body mass index (BMI) were 45.85 (SD 9.74) years old and 24.36 (SD 3.73) kg/m2, respectively. Nineteen donors (47.5%) had maladaptive hyperfiltration outcomes. The hyperfiltration process was demonstrated by significant changes in renal arterial RI, urinary VEGF, NGAL, and HS levels (p&amp;lt;0.005). There was no significant difference regarding RI, urinary VEGF, NGAL, and HS levels between both groups. Several confounding factors (BMI over 25 kg/m2, familial relationship, age over 40 years old, and arterial stiffness) were significantly influenced by kidney hyperfiltration and outcomes (p&amp;lt;0.05). Conclusion: the hyperfiltration process does not affect the 30-day post-nephrectomy kidney function of the donors. Several other factors may influence the hyperfiltration process and kidney function. Further study is necessary to evaluate kidney function and its other related variables with a longer period of time study duration.</dc:description>
	<dc:publisher xml:lang="en-US">The Indonesian Society of Internal Medicine</dc:publisher>
	<dc:date>2020-10-04</dc:date>
	<dc:type>info:eu-repo/semantics/article</dc:type>
	<dc:type>info:eu-repo/semantics/publishedVersion</dc:type>
	<dc:type xml:lang="en-US">prospective cohort</dc:type>
	<dc:format>application/pdf</dc:format>
	<dc:identifier>http://www.actamedindones.org/index.php/ijim/article/view/1478</dc:identifier>
	<dc:source xml:lang="en-US">Acta Medica Indonesiana; Vol. 52 No. 3 (2020): Acta Medica Indonesiana; 264</dc:source>
	<dc:source>2338-2732</dc:source>
	<dc:source>0125-9326</dc:source>
	<dc:language>eng</dc:language>
	<dc:relation>http://www.actamedindones.org/index.php/ijim/article/view/1478/pdf</dc:relation>
	<dc:rights xml:lang="en-US">Copyright (c) 2020 Acta Medica Indonesiana</dc:rights>
</oai_dc:dc>